Being told to contact hospice, but not sure why

DaughterOHIO

My Dad is 83 and is being seen by the VA.  After a phone call between my Mom and his nurse we were referred to Hospice.  My Dad bounces from needing round the clock supervision to suddenly getting himself up dressed and moving around. Over the last two weeks we have had to see to all his needs, and we are getting up 5+ times a night so he can pee, he can’t do that himself, and it takes 2 people to hold him up. Most days he has to be watched. He has no short-term memory and therefore forgets so he can barely walk and will fall. My mom sees this new decline as a sign.

Today he got up, and everything was normal, walking, talking, eating no assistance needed.  He goes through these phases.  We are hiring home care which starts next week to give my Mom 82 a break 10 hours per week.  They live with us. 

What are they seeing that I am not, and what would hospice actually do at this point?

terei

Hospice will be able to offer you services that are covered by Medicare.  Nurses aids to help with showering or other needs, equipment, supplies like depends, counceling for your family + meds that are sometimes needed for comfort at the end of life. They will help advise you on treatment + practical information about what to expect as your father declines.

There is no downside to hospice helping you.  If the VA medical staff is advising you to bring hospice on board, they believe your father is closing in at the end of his life + medical interventions except to make him comfortable are not prudent.

chrisp1653

I was confused when it was suggested that my Barbara be put on hospice too, but it worked out so much better for her, with the regular bathing aide coming in, regular nursing visits, and even a social worker. Plus, medicare then paid for all her supplies and basic comfort meds. It was a godsend for us.

Cynbar

Hospice can be a real source of support for all of you, not just your father. You will have a RN case manager who will monitor his physical health, tell you what to expect and give you tips on how to care for him. Home health aides will come at least several times a week to help with his bathing and other personal care, taking some of the burden off the family. A social worker, chaplain, volunteers and a homemaker will be added as needed. And medical equipment will be provided at no charge, as well as all medications related to his hospice diagnosis. There is really no reason not to try it, you can always stop if it isn't working for some reason. You may however want to interview a couple of agencies, as they differ somewhat in what they cover. Some don't include incontinence supplies, for instance, while others do. Choose the one that works best for you.

jfkoc

You are likely not missing much but someone thinks you could qualify for the extra help for your husband. I would definitely try.

Do interview several before making a choice.

eaglemom

As several have said Hospice is a good thing. They will come in and assess your dad. They may or may not qualify him. They help they provide can be such a lifeline for you.

Ask around to see if others have used a certain Hospice company. You need it to be a good fit for all of you.

eagle

manuzito

DaughterOhio, my DH was also a VA patient.  He was diagnosed with dementia in 2017 and was prescribed only one mood medication.  In 2019 he had a bad hallucination and when I phoned his geriatric doctor he prescribed a medicine that gave him a terrible reaction.  I phoned his doctor again and he said that it was time for my DH to get hospice care. My DH had good and bad days like yours and I declined hospice service because I thought I could manage his bad days.  One day he fell in the bathroom and I had to call for help.  After his fall I decided to take the hospice service and I regretted not having done it sooner.  

Like other posters said, hospice doesn’t always mean ‘end of life’ service.  My DH was on and off hospice for the last two years until his passing in December 2020.  He received excellent care from all the staff assigned to him.  The only thing that I didn’t like was the list of medications that they intended to give him.  I refused most of them until they were absolutely necessary and after checking with his primary doctor.

Good luck finding the right agency to fit your DH needs.

DaughterOHIO

Manutizo:

We were told by Hospice that we would not be able to have VA care, if we take on Hospice.  That is our main hesitation.  We are able to get help a couple of hours a week.  There is no money in the family so we have to take what we can get.  My Mom cannot physical and mental still provide for him.  Medicaid is offering us no help, self pay is not an option.  We are trying to sort it all out.

Did you still receive benefits from VA after you signed up with Hospice?

Cynbar

That is the only downside to hospice ---- it is comfort care only, and patients no longer pursue aggressive treatments or diagnostics. Most patients no longer see specialists, they can see their PCP but most don't do this either. There would be no more tests like MRIs, no more treatments like chemotherapy. Patients generally are not hospitalized but are treated at home by the hospice nurse (who does consult with the doctor.) Most VA services and clinics are considered curative. IV hydration and feeding tubes are usually not done. There are some exceptions, such as a treatment continued for comfort or pain control, but that isn't the intent of hospice philosophy. Some patients and families are never ready to take that step.

manuzito

DaughterOhio, my DH continued to receive VA services after he started hospice.  He was given 14 hours a week of in home help, his medications at no charge, a hospital bed, a walker and a wheelchair.  Before the pandemic started I took him to the VA Clinic to have his nails trimmed and have lab work ordered by his PD.  All this was done while he was already having hospice services.  The only thing hospice told me was that if my DH was taken to ER in a hospital then hospice would end and I would have to reapply for services.

  VA also gives respite time to caregivers.  Since I didn’t take any respite hours during the year, I was entitled to 80 hours in December when he needed night shift care during his last days of life.

Your father’s doctor can set him up with hospice so that he can get VA and Medicare services. I tried getting all the help available because I couldn’t possible afford out of pocket expenses. 

My DH is now resting in a peaceful Veteran’s Cemetery where I’ll be placed next to him when my time comes.